Search results

The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the prison healthcare setting, and explores if these reasons for visits differ by age group (49 years and younger vs 50 years and older). The authors used 50 years and older as the benchmark for older prisoners in light of literature indicating accelerated aging among prisoners.

Retrospective information from medical records of 406 prisoners were collected for a period of six months. This study analyzed the reasons for which prisoners visited the nurses and GPs available to them through the prison healthcare service. These reasons were coded using the International Classification of Primary Care-version 2. Data were analyzed descriptively and four generalized linear models were built to examine whether there was an age group difference in reasons for visiting nurses and GPs.

The health reasons for visiting nurses and GPs by 380 male prisoners from 13 Swiss prisons are presented. In the six month period, a total of 3,309 reasons for visiting nurses and 1,648 reasons for visiting GPs were recorded. Prisoner participants’ most common reasons for both visits were for general and unspecified complaints and musculoskeletal problems. Older prisoners sought significantly more consultations for cardiovascular and endocrine problems than younger prisoners.

Nurses play an important role in addressing healthcare demands of prisoners and coordinating care in Swiss prisons. In light of age-related healthcare demands, continuing education and training of both nurses and GPs to adequately and efficiently address the needs of this prisoner group is critical. Allowing prisoners to carry out some care activities for minor self-manageable complaints will reduce the demand for healthcare.

This study presents unique data on healthcare concerns for which prisoners visit prison nurses and GPs. It highlights the varied needs of older prisoners as well as how these needs are addressed based on the availability of the primary healthcare provider within the prison.

The purpose of this paper is to study the factors associated with the occurrence of diseases and beriberi among prisoners incarcerated in the two largest Remand and Correctional Facilities (RCF).

This was a cross-sectional descriptive and analytical study carried out from April 20 to May 19, 2017, in the RCFs of Ouagadougou and Bobo-Dioulasso. All prisoners who consulted and those referred to the health center by the health-care team were included in the study. Complaints and diagnosed diseases information were collected using the second version of the International Classification of Primary Care (ICPC-2). The authors used a logistic regression model to perform univariate and multivariate analyses.

Of the 1,004 prisoners from the two RCFs included in the study (32.6%), 966 (96%) were male. The median age was 31.6 years. The distribution of diseases diagnosed using the ICPC-2 showed a predominance of gastrointestinal tract, skin and respiratory tract diseases among 206 (19.3%), 188 (17.6%) and 184 (17.2%) prisoners, respectively. A total of 302 prisoners (30.1%) had clinical beriberi, and 80 prisoners (8%) were underweight. Being incarcerated for more than nine months was independently associated with a high risk of digestive and respiratory diseases as well as beriberi.

This study highlighted higher frequencies of digestive, skin and respiratory complaints and diseases in the two largest detention centers in Burkina Faso. These diseases are variously related to age, penal status and length of incarceration. In addition, underweight and thiamin vitamin deficiency responsible for beriberi are more frequent in adult prisoners, those not attending school, convicted prisoners and those with a length of stay in detention of more than nine months. These concrete results should help define a strategy and priority actions needed to reduce morbidity in prisons.

The actions should include the intervention of specialists in the field of common diseases in prisons, the improvement of individual hygiene conditions and environment, the improvement of the quality and quantity of the food ration, a strategy to reduce prison overcrowding. Other actions must be planned to allow specific groups such as women and minors to have access to health care that is adapted to them. Beyond the central concern of promoting the rights of prisoners and humanizing prisons, actions to improve the health of prisoners are part of an overall public health approach with its socio-economic and environmental implications.

There is a need for a strong commitment from the State to develop a prison health policy that prioritizes the prevention of communicable and non-communicable diseases that are particularly prevalent in this context, without forgetting mental health and nutrition. This requires a collaboration of stakeholders based on better intersectorial communication, the implementation of a monitoring and evaluation system for the health of prisoners, an enhancement of the status of health-care providers working in prisons and an increase in the funding allocated to the health of prisoners with the mobilization of the necessary funds.

This study uses a primary health care classification to assess the health of inmates in a prison in Africa. It contributes to the weak evidence around prison health surveillance and health profiling of prisoners in Africa.

The purpose of this paper is to assess National Medical Care Survey data quality.

Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis.

Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved.

Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered.

Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited.

Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

High socioeconomic status (SES) is associated with better health and lower use of health care services in the general population. Among immigrants, the relationship appears less consistent. The purpose of this paper is to determine if the relationship between income level (a proxy for SES) and use of primary health care services for mental health problems differs for natives and five immigrant groups in Norway. It also explores the moderating effect of length of stay (LoS) among immigrants.

Using data from two registers with national-level coverage, logistic regression analyses with interactions were carried out to determine the association between income level and having used primary health care services for mental health problems.

For Norwegian men and women there was a clear negative relationship between income and service use. Interaction analyses suggested that the relationship differed for all immigrant groups compared with Norwegians. When stratifying by LoS, income was not associated with service use among recently arrived immigrants but was negatively associated among immigrants staying more than two years (with the exception of Pakistani and Iraqi women).

Country of origin and LoS should be considered when applying measures of SES in immigrant health research.

There may be an initial transition period for recently arrived immigrants where competing factors mask the association between SES and service use.

This study benefits from nationwide coverage, eliminating self-selection biases. It demonstrates the complexity of the relationship between SES and health care use.

The purpose of this paper is to assess the health status and risky behaviours of inmates in Nepal.

This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison in eastern Nepal from September 2014 to August 2015. Data were collected through face-to-face interviews from 434 randomly selected incarcerated participants using semi-structured questionnaires.

The mean age of 434 participants was 35.7 years (SD 13.3). The majority (84 per cent) had at least one current health problem, of which the commonest were respiratory (50 per cent), skin (38 per cent) and digestive (26 per cent). Alcohol (73 per cent) and cigarettes (71 per cent) were the most commonly used substances prior to imprisonment. Approximately, 27 and 11 per cent reported illicit drug use and injectable drug use prior to incarceration, respectively. A total of 204 inmates reported having intercourse with sex workers. Of these, 49 per cent did not use a condom in their last intercourse with a sex worker.

This paper illustrates that a wide range of physical and mental health problems exist among incarcerated people in Nepal. The study may lack generalisability, however, as it was conducted in a single male prison.

The paper suggests a need for medical, psychiatric and substance abuse care in correctional settings to improve the health status of the prison population. It is also important to develop screening policies for blood-borne viral and other infectious diseases in the prison.

This is the first study of its kind drawn from prisons in Nepal.

Poor access to healthcare and increasing demand for services represent a management dilemma how to balance between needs and costs. Scrutinising the concept of demand management and using a case study from Finnish primary care, the purpose of this paper is to examine the complexities of managing demand for health services.

Convenience has explained the popularity of walk-in clinics (WIC), making it an attractive demand management tool. By analysing the quantitative service utilisation data of frequent attenders at WIC, the paper exemplifies what enhanced access to care means for demand management of public welfare services.

High user rates and satisfaction indicate demand for this type of service; however, the establishment of WIC provided supplementary care for the high users of health services, most suffering chronic diseases.

Better understanding of the structure of service demand is needed in order to develop a more coordinated service system and to manage demand for public welfare services.

The study demonstrates the importance of identifying service utilisation patterns in managing demand. Instead of single solutions, a wider system-level perspective is essential.

Managing demand and facilitating access are core primary care attributes but there is little evidence about the impact of demand management strategies. The paper ties together important healthcare management issues: how to control demand and improve the access? Moreover, few studies have examined the frequent attendance at WIC. This paper presents a practical illustration of demand management tool and indicates some demand management problems to be considered in healthcare management.

This case study describes a community-based urgent care clinic in a general practitioner (GP) super clinic in South East Queensland.

This retrospective chart audit describes patient demographic characteristics, types of presentations and management for Sundays in 2015.

The majority of patients (97%) did not require admission to hospital or office investigations (95%) and presented with one condition (94%). Of the presentations, 66.5% were represented by 30 conditions. Most patients received a prescription (57%), some were referred to the pathology laboratory (15%) and some were referred to radiology (12%). A majority (54%) of patients presented in the first three hours. Approximately half (51%) of patients presenting were aged under 25. More females (53%) presented than males. A majority (53%) lived in the same postcode as the clinic. The three most common office tests ordered were urinalysis, electrocardiogram (ECG) and urine pregnancy test. Some patients (19%) needed procedures, and only 3% were referred to hospital.

The study offers analysis of the client group that can be served by an urgent care clinic in a GP super clinic on a Sunday. The study provides an option for emergency department avoidance.

Despite calls for more research into community-based urgent care clinics, little is known in Australia about what constitutes an urgent care clinic. The study proposes a classification system for walk-in presentations to an urgent care clinic, which is comparable to emergency department presentations.

This study aims to investigate the impact of regular Kung Fu and Taekwondo practice on the health and quality of life among elderly individuals in the Maule region, Chile.

The authors designed a 12-week Kung Fu and Taekwondo workshop with activities suitable for their age. Through semistructured interviews (at the beginning and the end of the workshop), along with periodic monitoring of vital signs and cardiovascular components, the authors observed an improvement in participants’ physical (strength, speed of reaction and flexibility) and psychological conditions (self-esteem and resilience), quality of life (relationships with family and friends and ability to deal with stressful events in working life) and health (waist circumference, percentage of oxygen saturation in blood, blood pressure, among other values).

From these results, the authors affirm that this workshop improves health and physical condition and helps the participants develop the coping capacity to deal with stressful situations and complicated interpersonal relationships. In this sense, the authors conclude that Kung Fu and Taekwondo as regular sports activities can benefit senior citizens’ aging process.

This research is based on an original study project.

The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population.

The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland’s largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician.

In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026).

In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient’s area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.

Body-packing means concealing packets of illicit psychoactive substances in the digestive or genital system. The purpose of this paper is to investigate profiles of body-packers and comorbidities associated with body-packing.

A retrospective study (2005–2016) was conducted among all patients hospitalized for suspicion of body-packing in the Geneva hospital prison unit (n=287). Data were extracted from medical records and included demographics, somatic/psychiatric diseases, suicidal ideation and psychological distress.

Body-packers were mostly young men (mean age=33.4). A total of 42.2 percent of the participants had at least one psychiatric or somatic comorbidity reported during incarceration (somatic: 28.2 percent, psychiatric: 18.8 percent). The most frequent somatic diseases were infectious (10.5 percent), cardiovascular (10.1 percent), and endocrinological (4.2 percent) diseases, and more precisely HIV (4.5 percent), hepatitis B (3.5 percent), hepatitis C (1.4 percent), high blood pressure (8.0 percent) and diabetes (4.2 percent). The most frequent psychiatric conditions were substance use disorders (10.5 percent) and mood disorders (8.0 percent). Depressed mood/psychological distress and suicidal ideation were frequently reported during hospitalization (27.2/6.6 percent). Comorbidities were associated with demographics: Females were more likely to have somatic and psychiatric diseases detected during hospitalization in detention and participants from Western, educated, industrialized, rich and democratic countries were more likely to report diseases known before detention.

Body-packers bear a heavy burden of disease and psychological distress. This vulnerable subgroup of incarcerated people has been overlooked in previous research and their health needs are not correctly understood. This study was a first step to improve their health care and reintegration.